Obesity: A Precursor to Diabetes and Much More

We could maybe blame it on technology and the modern conveniences of life; or probably, to the continuous “westernization” of societies all over the world. But with all the advantages that modern society brings, there is one truth that cannot be denied: people have become more sedentary.

Children, who used to run around the streets playing tag or hide-and-seek with their neighbors, now stay at home and sit in front of the play station or computer with only their fingers and their eyeballs moving.

Meanwhile, adults veer away from using the stairs because of the convenience of the elevator or escalator. They have also forgotten the pleasure of walking, preferring to drive to wherever they are going, no matter how short the distance may be.

The rise in physical inactivity and the predominance of fast foods have caused devastating effects on the health of every individual today. One dreadful result is the prevalence of overweight and obesity, which put people at risk of lifestyle-related diseases like hypertension or high blood pressure, high cholesterol, stroke, heart diseases, and diabetes.

Defining the Root of the Problem According to the American Heart Association (AHA), obesity means having too much fat in your body. “Your body is made up of water, fat, protein, carbohydrate and various vitamins and minerals. If you have too much fat—especially in your waist area—you’re at higher risk for health problems, including high blood pressure, high blood cholesterol, diabetes, heart disease, and stroke,” warns the AHA.

So how does one become at risk of becoming overweight and obese? “Genetic predisposition, hormonal problems such as hypothyroidism, some medications such as steroids, but most importantly, a bad diet and a sedentary lifestyle,” says Dr. Marie Yvette Rosales-Amante, an endocrinologist at the Asian Hospital and Medical Center and director of the American Association of Clinical Endocrinologists (AACE)- Philippine chapter.

Dr. Rosa Allyn Sy, president of the Philippine Association for the Study of Overweight and Obesity (PASOO), also included in the list certain environmental factors—”exposure to fast food at an early age, exposure to soft drinks and high caloric energy dense food that are high in calories but cannot give proper nutrients.”

A Rising National Concern
A study done by the PASOO through a grant given by Servier Philippines and then PASOO president, Dr. Augusto D. Litonjua, looked into the prevalence of obesity in medical practice. Randomly selecting 164 general practitioners nationwide, they asked 1,220 patients to answer a survey and participate in a project which lasted from April 1996 to December 1998.

“Using the IOTF-WHO (International Obesity Task Force-World Health Organization) classification of obesity, the study showed that the prevalence of obesity in medical practice in the Philippines is 21 percent, while 25 percent of consulting patients are overweight,” says Dr. Sy, who at the time of study was treasurer and director of PASOO. “Unfortunately, only four percent of the subjects included consulted because of their weight problem and 96 percent consulted for other reasons. For those who recognized their weight problem, only eight percent of these subjects were doing something about it, while 64 percent are not concerned and 28 percent did not give any answer,” reveals Dr. Sy.

Sadly, these figures only hold true for those selected patients, but this is not the case when we look at the statistics for the entire country, adds Dr. Sy. And this is why constant vigilance in weight gain is becoming a physician’s top priority.

Targeting One’s Health and Perception
In a society that promotes thin bodies and perfection, overweight and obese people may start having personal issues that could greatly show in how they look at themselves and how they mingle with others. “When you talk about obesity itself, it doesn’t only affect one person’s health, but it also affects one person’s perception about himself or herself, especially if it’s a woman or a teenager. Because when you look at an obese adolescent for example, it’s not cute anymore. So self-esteem is affected,” says Dr. Yolanda E. Oliveros, director of the National Center for Disease Prevention and Control.

Dr. Sy likewise believes that being overweight and obese have gone beyond the boundaries of just being a cosmetic problem, “There are health reasons why we are telling our patients to lose weight,” she says. Some of the problems that could occur due to obesity, according to the AHA, is that it could “raise blood cholesterol andtriglyceride levels, lower HDL ‘good’ cholesterol, raise blood pressure levels, and can induce diabetes.”

Adding to that, “The obese individuals are at risk to develop all the metabolic problems and cardiovascular problems. Meaning to say, they could get gall bladder stones and heart diseases like getting a heart attack. They could also get peripheral vascular disease if there’s a blockage in their arteries in the feet, or if there’s a block in the brain, they can get stroke,” cites Dr. Sy.

Dr. Oliveros says the way parents raise their children, even while still in the mother’s womb, is a precursor to how healthy the child could be. How kids are kept away from unhealthy food and encouraged to engage in physical activity can define if a child would be obese or overweight in later life.

“Studies have shown that the risk of developing diabetes or other non-communicable diseases like cardiovascular disease, hypertension in later life is being dictated by the way the infant is being taken care of, or how the fetus is being conceived in the womb,” says Dr. Oliveros. “It has been found out that those infants who were born large for their gestational age and who were born through a diabetic mother would have higher risk of developing diabetes and other non-communicable diseases in their later life,” she adds.

Unfortunately it doesn’t end there. Studies show that babies who aren’t breastfed have a higher risk of becoming obese and this could lead to the development of diabetes and other diseases, compared to babies who were exclusively breastfed.

What’s more, kids who are exposed to junk food or other foods with high calories but promise no nutrition, are also at risk of obesity and being overweight.

Dr. Sy believes that parents should be the ones responsible in educating their children and giving their kids pointers on what and what not to eat. “They should first recognize and be aware that being overweight is a problem. Second, because of our culture, parents have a tendency to want fat children because they think that fatness correlates to health. But I think because of increasing awareness, there is now a change in this attitude,” says Dr Sy.

Diabetes and Obesity
All doctors interviewed are one in saying that if one doesn’t take the necessary precautions to avoid being overweight or obese, complications may arise and one of these is diabetes. The International Diabetes Federation estimates that “at least half of all diabetes cases would be eliminated if weight gain could be prevented.”

However, being overweight or obese may not mean that you would acquire diabetes. Dr. Oliveros says that “several studies all over the world are being done right now to link obesity with diabetes. But we’re not saying that if you are obese you would be diabetic. It’s not that parallel. You might be obese but you will not develop diabetes.”

Having said that, Dr. Oliveros adds that it does not mean that one could eat whatever and how much they want to eat, or stay inactive. But since reports havealready supported the idea of the correlation of obesity and diabetes, something must be done about it.

For those who diabetic and are still overweight and obese, slowly starting to lose weight could be of great help as “being overweight with diabetes may mean greater need for medications to contra/ blood sugar, cholesterol, and blood pressure,” advises Dr. Amante. “These parameters are more difficult to normalize if a patient is overweight or obese. Definitely this may mean more, and earlier develop t of complications,” she Waths.

Adding some more diabetes complications that obesity may bring about, Dr. Sy mentions, “if you are obese, even if you don’t have diabetes, you’re chances of getting a stroke is high. On the other hand, if you’re diabetic and obese, chances of getting:a heart attack or stroke increases by several fold.”

Taking that Bold Step
“I think aside from the parents, community will play a big role. It’s a community’s responsibility,” suggests Dr. Sy. She further adds that government intervention, especially through the Deportment of Health (DOH), could help give policies on how to really improve healthy lifestyle, which would be of great help in curbing the obesity problem.

“Aside from that, food should also be regulated in the sense that they must be labeled properly, so that if consumers are already educated they’d know which are unhealthy and healthy. And the media will ploy a big role, too. Educating them with the right things will help,” adds Dr. Sy.

But more than anything else, change should start from one’s self. “Eat a balanced diet, take a lot of fresh food such as fruits and vegetables. Try to avoid processed food like hotdogs, canned food, highly refined carbohydrates such as cakes and doughnuts. Avoid food with zero nutrients such as soda. Avoid fatty food like chips and french fries,” advises Dr. Amante.

With regards to staying active, Dr. Amante says, “Pick a sport that you like and enjoy. Limit television, computer games, and computer use to a reasonable minimum during weekends. Stick with friends who are active and like sports as well,” adds.Dr. Amante.

To jumpstart a community-wide effort that would help reduce the statistics of obesity and overweight kids, Dr. Amante further suggests: “School canteens should sell only healthy food. Set up the environment for outdoor sports, make sure the parks are clean and safe. Have the family join a sports club or gym. Instead of going to the mall to watch a movie on weekends, how about going nature-tripping and go hiking or swimming. Or just bike around the village. Or set up a basketball league. Be serious about limiting TV and the use of computer and computer games. And the hardest part of all, BE A GOOD EXAMPLE OF A HEALTHY LIFESTYLE!”

Reaching Out to the Masses
To help in educating the people about the perils of overweight and obesity, many professional medical organizations are now putting up awareness campaigns to inform more people about the serious effects that being overweight and obese can bring about.

Spearheading the campaign against overweight and obesity is PASOO. “We have several activities that we’re holding to help improve awareness. For the doctors, we have the obesity workshop and the annual convention which is the scientific as – teaching, updating them on the new trends.” says Dr, Sy.